Inside:

Interview with NorthLakes CEO, Reba Rice

Community Programs& NorthLakes Community Clinic

NorthLakes Clinics and Services

In a recent interview, NorthLakes CEO Reba Rice talked about growth, what it takes to get upstream of major health issues, and the counterintuitive thing the NorthLakes team has learned about how people get well.

WhatdoesitmeanwhenyousaythatNorthLakesis“morethanaclinic”?

Our board has tasked us with finding ways to get outside the walls of our health center to work toward the engagement, the prosperity and health of our community members. They said, “you can’t just offer medical services – you’ve got to go out and get to the root cause of the issues,” and those hap-pen outside the clinic.

And so if we’re going to start addressing the root causes we’ve got to start seeing that issues like obesity are is-

sues of malnutrition. That diabetes is linked to not having walkable communities. That the prevalence of health problems we address in our clinics from depression to tooth decay to hypertension all start in people’s homes and in their lives and in their schools. Our job as a public health organization is not just to provide services that professionals can offer in a clinic but to engage the community in figuring out what it needs to improve its own health.

A community can improve its own health by addressing the issues that it sees as most pressing to itself. So if there’s critical mass around exercise, or access to better food, or living wage jobs, then the community will be passionate and engaged with that and will embrace the changes it needs to make. Because it doesn’t just matter what the needs are; it also matters what the resources are. And when you match those things, the things you need to accomplish with the resources that you have, you find synergies, and things start to fall together. You find you have the problem AND the thing to solve that problem. Then you really have something, rather than just sitting around a table and identifying all the issues and saying all the things you need when you have no idea where they’re going to come from.

NorthLakes is one of the many resources that the community has. And we’re saying “Put me in, coach!” But we’re not the whole team, or the coach. We’re just one of the resources.

Whatdoesthatlooklikeinpractice?

Some idea or program comes up in conversation. It’s like a little ball that spins around, and other stuff gets attached to it. Maybe someone else has heard of that program, or we have an extra room, or a patient says they have a need, and we just heard about a provider. So things just start to attach to this little idea and it gets bigger and bigger. We have learned, organically, that when we float something and three or four other things don’t come and attach to it, we should just let it go for the time being, even if it’s a great idea. If we don’t have several things going in that direction; a provider, a need, a space, a grant – we don’t even pursue it because it’s not going to be the low-hanging fruit.

And so what we’ve learned is that, as long as they are all good ideas, you do the easy stuff first, and there’s always an easy thing waiting for you to do it.

BoardofDirectorsOfficers

President Robert Holman -MinongVice President Beth Probst -Iron RiverTreasurer Stephanie Laakson -HaywardSecretary Peggy Hipsher -Tripp

MembersCarol Anderson -Iron RiverChristine Austin -Iron RiverPat Deragon-Navarro -Red CliffRick Dowd -AshlandLouise Heim -HaywardJohn Joseph -Iron RiverPatsy Quick -MinongAdrienne Sather -MinongDr. John Schrock -BruleJane Snilsberg -Iron RiverMark Witmer -Minong*John Hermeier -Wascott*Wendy Kloiber -Ashland*Ruth Ritter -Ashland

Chief Executive OfficerReba Rice

Chief Operations OfficerJason Akl

Chief Financial OfficerBrian Ahlgren

* Resigned in 2014

ThankYou

to the many Foundations,

& Organizations that have provided

generous grant awards supporting our Mission.

u HRSA(U.S. Department of Health

and Human Services: Health Resources and

Services Administration)

u HRSA Extended Services

u Bremer Foundation

u WI Department of Health Services

u Office of Rural Health Network

u Public Service Commission of WI

u Delta Dental of Wisconsin

u Children’s Health Alliance

u United Way

An example of this is our new Prescription for Wellness program. We’d been talking about – for a long time – getting upstream of major health issues, and trying to figure out what’s the problem? Why can’t we get upstream? And then we got it: it’s because we’re always inside of our health center, instead of being in people’s lives. So we developed the idea of Prescription for Wellness. Then a federal Expanded Medical Capacity grant that came out, which we are required to use for a medical-based program. That gave us an opportunity to be strategic. And at the same time an incredible person, Linda Rise, had come to us and said “I want to work for NorthLakes,” I had carried Linda’s resume around for a long time, and we carried this idea of Prescription for Wellness around for a long time, we had this Expand-ed Medical Capacity grant that we were trying to use to take us beyond the clinic walls, and then it just fell into place and we could tell - it was like a key in a lock: and the tumblers line up all together and then you can go.

We’re piloting the program now. It allows providers to give prescriptions for healthy food and exercise, and eventually we’ll add social interaction and other elements that contribute to wellness. We’ve created a special prescription pad, because there’s some evidence that when something is prescribed, it means more to patients than when it’s recommended. And the program is creating partnerships with local businesses that are the real resources for healthy food and exercise, like the Chequamegon Food Co-op and The Spot, which offers yoga and fitness classes, and Ignite Fitness, and many others.

Whathaveyoulearnedthat’scounterintuitive?

Doctors can’t make people well. Only people can make themselves well. Being “more than a health center” is about changing the locus of control, taking it away from the health center and giving it back to the patients.

From a patient perspective it means that I as a patient am empowered by my doctor to make decisions. I’m educated by my doctor and my team about the important issues that I need to choose between, including the side effects, the costs. I understand them; it’s not just a bunch of Latin; I get it. And then I’m really in the driver’s seat, and it’s not about the doctor’s goal, it’s about mine. It’s totally appropriate that my doctor’s goal is that I be healthy. But my doctor’s goal is not what’s important. Because my goal may be just to enjoy my last six months of life. Or to not have my family know that I’m sick. Or go from 9 beers to 6 beers a night. It doesn’t matter that the doctor wants me to have zero beers a night. So as a patient, that’s what it looks like: I’m in charge, I know I’m in charge, and I don’t want to or get to abdicate that responsibility. I don’t see my doctor and my health team as the person who decides. They are teachers and coaches, but I’m responsible for my performance.

From the clinic side, it’s a lot more fun, as a provider, to work on a health project with every single patient, which is the project the patient has chosen. Every single person on the NorthLakes staff this year will learn motivational interviewing, which is a tool that asks, what do you want as a patient and what’s stopping you from getting that? Patients can ask themselves, why do I want to eat the stuff I’m eating even though I’m unhappy with my weight at the end of it? Asking those questions gets me closer to the root cause of what is jeopardizing my health or really, all my goals.

Providers feel the difference when they’re talking with their patients - the level of engagement changes when they’re saying “What is it that you want and how can I help you accomplish that?”

2-NorthLakes Community Clinic www.northlakesclinic.org -3

Whatdoesitmeanwhenyousay... NorthLakesis“morethanaclinic”?

Being “more than a health center” is about changing the locus of control, taking it away from the health center and giving it back to the patients.

ThankYou4-NorthLakes Community Clinic

CommunityDonors:

Thank you for your generosity. We would like to thank you for your generosity and support of NorthLakes Community Clinic. When the call for care is received, we are able to respond, ensuring that no one in need is turned away.

Akl, Jason

Alexander, Joseph

Anderson, Charles

Anonymous

Ashland Area Council

Asp, Grace

Austin, Christine

Boggess, Thomas

Bohaty, Adolph

Brierly, Joan

Brunner, Linda

Craig, Nancy

Dryer, Deb

Dunn, William

Dunster, Patricia

Dzialo, Eleanore

Fabiilli, Stephanie

Fanning, William

Foss, Margaret

Garnello, Andrea

Garnello-Johnson, Heidi

Gerry, Kathleen

Gilberg, Nina

Gougar, Janet M

Hamilton, Rosemary

Hannickel, Erica

Herstein, Tim

Hoiby, Geraldine

Holman, Robert

Homeless Fund Donation

Johnson, John

Kesler, Margy

Knapp, Myron

Koeller, Arlyn

Kolonko, Deborah

Kruger, Catherine

Laliberte, Raymond

Lind, Rudy

Linder, Curtis

Mattila, Nigel

McFarland, Mary

Meierotto, Mary

Mitchell, Sheila

Morud, Clair

Mundle, Edward

New, Gary

Nichols, John

Olson, Robert

Polecheck, Andrea

Polus, Roxy

Pyykola, Urho

Rakow, Christine

Randa, Steven

Rexses, Donna

Rice, Robert

Riley, Michael

Serum, Jean

Spangle, Randy

Suo, Katherine

Thiel, Karen

Thimke, Jane

Thompson, Dodson

UHC

Wasco, Ken

Weiss, James

Westergren, Marion

Yrjanainen, Andrea

www.northlakesclinic.org -5

Sources  of  Funds  

Insurance  and  Pa,ent  Fees  Government  Grants  Contribu,ons  

Other  Income  

Uses  of  Funds  

Provision  of  Primary  Health  Care  

Management,  Facili8es,  IT,  Billing  and  General  

 Current  Assets    

Current  Liabili/es  

Property  &  Equipment  

Long-­‐term  Liabili/es  

Net  Assets  

 -­‐        

 1,000,000    

 2,000,000    

 3,000,000    

 4,000,000    

 5,000,000    

 6,000,000    

 7,000,000    

Assets   Liabili/es  &  Equity  

Balance  Sheet  

FinancialInformation:

The following is an overview of our finances from January 1, 2014 to December 31, 2014.

SourcesofFunds Insurance and Patient Fees 9,488,000 Government Grants 2,281,000 Contributions 57,000 Other Income 300,000 Total 12,126,000

BalanceSheet Assets Current Assets 2,592,000 Property and Equipment 3,180,000 Total 5,772,000

LiabilitiesandNetAssets Current Liabilities 763,000 Long Term Liabilities 713,000 Net Assets 4,296,000 Total 5,772,000

UsesofFunds Provision of Primary Health Care 9,485,000 Management, Facilities, IT, Billing and General 2,117,000 Total 11,602,000

Wearecommunitydirected,withpatientsmakingupmorethanhalfofourgoverningboard.

2014PatientDataNumber of patientsserved in 2014:

13,338

Number of visitsin 2014:

47,507

Service visitsin 2014:

*Note: Other- ST (Speech Therapy) and OT (Occupational Therapy) began towards the end of 2014.

Total full timeemployees in 2014:

134

Total number of health careproviders (full & part-time) in 2014:

38

With clinics in Ashland, Hayward, Iron River and Minong, NorthLakes is growing and expanding services to meet the needs of our patients and communities.

6-NorthLakes Community Clinic www.northlakesclinic.org -7

CommunityPrograms:Part of what makes NorthLakes “more than a clinic,” are these programs taking place outside our walls, where patients live, work, exercise, and go to school.

Seal-A-Smile:partofourSuperiorSmilesPrograms The Superior Smiles program operates under the State of Wisconsin statues and guidelines for school based services.

“One in three Wisconsin children are living with untreated dental decay, the most preventable chronic disease in the United States. Children and youth with special health care needs are twice as likely to have unmet dental needs. In addition, disproportionate levels of access to oral health care exist in minority and low-income populations. Nationally, 80% of dental decay affects 20% of children.” (www.chawisconsin.org)“It has been estimated that more than 54 million school hours are lost yearly because of dental disease.” (www.dhs.wisconsin.gov)

Our Superior Smiles team provided services in 66 schools throughout 11 counties and have seen just over 5,650 children in 2014. This program includes oral health education and dental supplies, oral health assessment by a licensed dental professional (Dental Hygienist

or Dentist), fluoride varnish applications and dental within the schools.

• Every child is eligible for the program regardless of insurance• Superior Smiles visits the school three times per year• A report is sent home after each visit listing what services were provided• Superior Smiles works with local community dentists to increase access for care to children with no dentist.

PrescriptionforWellness This spring, NorthLakes Clinic is beginning its Prescription for Wellness program, which will allow providers to write prescriptions for healthy food and exercise. Program director Linda Rise has been making connections with many local partners who can help facilitate prescriptions. The Chequamegon Co-op is offering free classes to prescription holders and local yoga and fitness partners Humble Be Yoga, The Spot Wellness and Ignite Fitness offer memberships at reasonable prices.

Rise says motivational interviewing gives the program a lot of its power. “We can pull together a lot of resources but what matters most is for prescription holders is to find what motivates them,” Rise said. “Once people find their own motivation for making healthy choices, the barriers become easier to navigate.”

Prescription for Wellness is piloting with three providers and will expand throughout 2015.

NorthLakesCommunityClinic:

ASHLAND:CHILDREN’SCLINIC 719 Main St E, Ashland, 54806P) 715-685-2200 -or- 888-834-4551 F) 715-685-2202Services: Dental, Behavioral Health Counseling, Speech Therapy, Resource Coordinator

ASHLAND:VAUGHNCLINIC 502 W Main, Suite 305, Ashland, 54806P) 715-682-5207 F) 715-682-5209Services: Adult Behavioral Health Counseling, Substance Abuse/ AODA Counseling

ASHLAND:THIRDSTREETCLINIC 422 Third Street W, Suite 135, Ashland, 54806P) 715-682-0633 F) 715-682-0736Services: Pediatric Occupational Therapy, Pediatric Speech Therapy

HAYWARDCLINIC 11128N St Hwy 77, Hayward, 54843P) 715-634-2541 F) 715-634-5740Services: Medical Services + Prenatal/ OB care, Osteopathy, Behavioral Health Counseling, Substance Abuse/ AODA Counseling, Resource Coordinator

HAYWARD:EVERGREENCLINIC 15910W Company Lake Rd, Hayward, 54843P) 715-934-2224 F) 715-934-5740Services: Dental

IRONRIVERCLINIC 7665 US Highway 2, Iron River, 54847P) 715-372-5001 -or- 888-834-4551 F) 715-372-5067Services: Medical, Chiropractic, Dental, Behavioral Health Counseling, Substance Abuse/ AODA Counseling, Pediatric Occupational Therapy Treatment, Physical Therapy through OST, Patient Pharmacy, Resource Coordinator

MINONGCLINIC 600 Shell Creek Road, Minong, 54859P) 715-466-2201 F) 715-466-2205Services: Medical Services + Prenatal/ OB care, Osteopathy, Behavioral Health Counseling, Substance Abuse/ AODA Counseling, Physical Therapy through OST, Patient Prescription Services, Resource Coordinator

CommunityPrograms

u ACA- Marketplace.com Enrollment / Educationu Seal-A-Smile (part of our Superior Smiles Program)

u School Based Restorative (part of our Superior Smiles Program)

u NorthLakes Mobile Senior Dental Clinic (part of our Superior Smiles Program)

u Head Start Program (part of our Superior Smiles Program)

u Prescription for Wellness

u Mercury/Fish Project u Mini Food Shelf (in partnership with Second Harvest Northern Lakes Food Bank in Duluth)

NorthLakesisoneoftheresourcesthatthecommunityhasandwe’resaying“Putmeincoach!”WhatisaCommunityHealthCenter? A Community Health Center, such as NorthLakes Community Clinic, works to improve the health of its community.

WhocangotoNorthLakes? NorthLakes provides high quality health care for anyone who needs it, regardless of ability to pay, insurance coverage, or where they live.

ClinicLocations&ServiceArea

WhoWeAre(CHC)

NorthLakes Community Clinic is proud to be a Community Health Center (CHC). As a Community Health Center, NorthLakes is a non-profit organization managed by a patient majority board of directors. Community Health Centers provide care to everyone, including those with commercial insurance, those with government insurance (MedicAid and MediCare) and those without insurance. In addition, Community Health Centers provide comprehensive, integrated, whole person care including medical, dental, behavioral health and prescription services.

OurMissionTo respond to the health care needs of our communities with an integrated array of quality services and actively remove barriers to care.

OurVisionHealthy, prosperous, engaged communities where everyone thrives.

Ashland - Hayward - Iron River - Minong

7665USHighway2 IronRiver,WI54847